Complementary and alternative medicine (CAM) refers to a group of diverse medical and healthcare systems, practices, and products not treated as conventional medicine. The body of literature on stress and stress management among young adults has not addressed the use of CAM modalities for stress management among this population. The theoretical foundation of the study was based upon the transactional model of stress and coping, which describes stress as an interaction between an external stressor and the resources available to eliminate the stressor. The purpose of this quantitative study was to examine whether variables such as exposure to CAM, stress level, dispositional coping style, sociodemographic variables, and social support influence young adults' use of CAM modalities for stress management. This study sought to determine to what extent dispositional coping, exposure to and knowledge of CAM, and sociodemographic variables affect young adults' use of CAM modalities for stress management. This study also sought to answer whether there is a difference in the perceived stress of participants who use CAM modalities and those who do not. A quantitative cross-sectional correlational study was employed, using a survey methodology, to identify whether the factors identified in the study influence young adults' use of CAM modalities. Results showed that knowledge of CAM and dispositional coping style significantly influence the use of CAM modalities; sociodemographic variables do not influence the use of these modalities. Furthermore, the use of CAM modalities was found to have a significant relationship to stress level. The findings of the current study suggest the CAM techniques can be adapted and introduced into college settings so that students can better manage their stress levels

In the United States, influenza causes approximately 36,000 deaths and over 200,000 hospitalizations each year with elderly most often affected. Clostridium difficile infection (CDI) is another major health care challenge and pressing public health issue associated with 14,000 deaths and over 335,000 hospitalizations annually. The use of antibiotics has been implicated in the development of CDI. This study's purpose was to test the relationship of seasonal influenza incidence and antiviral/antibiotic use in CDI development among hospitalized patients. Grounded in the epidemiologic wheel model of man-environment interactions, this retrospective observational study described and analyzed data from a proprietary, laboratory, and pharmacy-based system from a cohort of hospitals. The association between 147 patients with a diagnosis and/or positive test for influenza, the independent variables of delivery of antivirals/antibiotics (n = 130) during the patient's hospitalization, and the dependent variable of positive test or diagnosis of CDI (n = 17) was tested using multiple logistic regressions. The study results did not prove to be significant for the 3 research questions, suggesting no impact of antiviral use (R2 = .05, p = .336), antibiotic use (R2 = .05, p = .290), or antiviral and/or antibiotic use (R2 = .04, p = .382) on development of CDI within 60 days of discharge. However, findings indicated that recommended antiviral medication was inconsistently administered to influenza positive patients and that inappropriate prescribing patterns for antimicrobial agents coincided with seasonal influenza. Implications for positive social change include confirming the importance of antibiotic stewardship as an essential aspect of quality healthcare.

This project study addressed the problem of a decline in retention of students at a local allied health college. The need for allied health professionals is projected to exceed the availability by 2020, so it is important to identify strategies to help allied health students succeed. The purpose of this case study was to explore perceptions of students and faculty about motivating factors and learning strategies that foster successful progression in allied health programs. Ryan and Deci's self-determination theory, focused on the relationship between motivation and success, served as the framework for the study. Research questions addressed intrinsic and extrinsic factors that students and faculty identified as significant in motivating successful completion of core courses. Data collection included information from the college effective plan from the research site and face-to-face audio-recorded interviews with 10 allied health students and 5 faculty. Students were 18 years or older and enrolled in at least 1 core course in an allied health program; faculty taught at least 1 core course with at least 1 year of experience with allied health students. Interview data were analyzed through open coding to identify themes related to motivating student success in core courses. Significant motivating factors included improved quality of life (intrinsic) and a supportive learning environment (extrinsic). Motivating strategies for student success were active involvement in the learning process and hands-on learning. Findings from the study guided development of a 3-day learning community designed to support student success in core allied health courses. Positive social change may be impacted by motivating allied health students to succeed in order to meet the health care needs of clients.

Malaria is the main cause of mortality for children under the age of 5 in Burundi. The access to malaria diagnostics and treatment is hampered not only because of logistical issues, but also due to the lack of qualified human resources and their inequitable distribution across the country. To mitigate the lack of human resources for health, the government of Burundi, along with its partners, shifted some tasks to community health workers (CHWs) to cover unmet healthcare needs for selected diseases such as malaria, diarrhea, and pneumonia. The purpose of this study was to determine whether the social support provided to CHWs had an impact on morbidity due to malaria for children under the age of 5. The social networks and social support theoretical framework was used to explore the type of social support received by CHWs and its impact on the number of children treated. The 88 CHWs who participated in this cross sectional survey, were randomly selected from a pool of 719 CHWs who were part of a pilot project that was implemented in the districts of Gahombo, Gashoho, and Mabayi, from 2011 to 2014. The study findings showed mixed results with a positive correlation between the instrumental support received and the number of children under the age of 5 treated. However, a statistically significant correlation was not established between the emotional, informational, and appraisal support received and the number of children under the age of 5 treated. The positive social change implications of the study include providing evidence to build and enhance human resource capacity for improving the health of children living in Burundi, an under-resourced country, through the development of a support package that can be offered to CHWs to help them perform their duties in a more effective way.

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto design relied on secondary data from Saudi Aramco. Lifestyle data were collected from a health risk assessment including the Stanford Presenteeism Scale. Data analysis consisted of both a correlational and multiple regression analysis. Correlational results indicated that exercise, tobacco use, body mass index (BMI), and nutrition were significantly related to workplace productivity. Exercise and nutrition had a significant positive correlation with workplace productivity, while tobacco use and increasing BMI were negatively correlated with workplace productivity. Multiple regression analysis results explained 21% of the variance in the dependent variable, a sizable percentage with such a large sample. Overall, these results suggest a strong influence of health choices on productivity. Since this research was the first to explore the unique cultural context and draw attention to the increasing NCD burden, the results are notable. Implications of this research should resonate with organizational leaders in the Middle East, and provide a clear opportunity to improve organization and human performance.

There has been a shift toward e-cigarette use and away from tobacco smoking among American youth. Despite effects of ongoing public health campaigns that bring attention to the harmful effects of tobacco and nicotine use generally, youths might not perceive e-cigarette use to be unhealthful in terms of psychological functioning. This study was an investigation of the impact of the method of tobacco use (cigarette or e-cigarette), past cessation attempts, cravings or needs to use tobacco, and serious cognitive difficulties, upon youths' intentions concerning future tobacco usage. The conceptual framework was based upon the self-medication hypothesis, biopsychosocial model, and social cognitive theory. The research questions focused on whether factors surrounding youth tobacco use would significantly predict the youths' intent. Data were drawn from 2015, 2016, and 2017 National Youth Tobacco Survey (NYTS) responses. Cross-sectional data from 56,258 cases allowed for a total of 387 cases to be identified for inclusion in the analysis, based upon completeness of the data and inclusion criterion of a singular form of recent and regular tobacco use. Data were analyzed by using a chi-square test of independence and multinomial logistic regression. The research findings suggest that past cessation attempts and methods of tobacco use are variables that could significantly predict intent concerning future tobacco use; however, the findings did not suggest that craving or need for tobacco or serious cognitive difficulties significantly predicted these intentions. The study is replicable and amendable for purposes of more specific analyses. This research also contributes to the understanding of the e-cigarette epidemic, and the findings of the study can ultimately benefit young e-cigarette users who receive psychological treatment.

In spite of the National Asthma Education and Prevention Program guidelines outlining how to diagnose, treat, and educate asthmatics, asthma morbidity and mortality rates are still mounting. Furthermore, the minority population has disproportionately higher rates of unfavorable outcomes from asthma, thereby diminishing their quality of life. The study's theoretical framework was based on the health belief model and explored associations of asthma control with self-efficacy and asthma education. Few studies focus on asthma inequity. The purpose of this quantitative study was to assess relationships between asthma control, race, asthma education, and healthcare utilization amongst asthmatic children residing in the Midwest. Secondary data from the Centers for Disease Control's Behavioral Risk Factor Surveillance System's Asthma Call-back Survey were used (n=477,221). Participant characteristics were examined using descriptive statistics. A sequence of bivariate and logistic regression analysis was used to test each hypothesis. The findings revealed significant associations amongst asthma control, race, asthma education, and healthcare utilization. In addition, children with uncontrolled asthma have greater visits to the emergency department and to their pediatrician's office due to their asthma symptoms. Moreover, the study results indicated that African American children experienced uncontrolled asthma at a higher rate when compared to other children, consequently decreasing their quality of life. The study showed the need for policy change to expand funding and programs aimed at decreasing uncontrolled asthma by improving asthma education, especially in African American communities, in hope of empowering asthmatics to play a vital role in their health and increasing their quality of life.

Despite decades of the implementation of the directly observed therapy short-course (DOTS), Sierra Leone is ranked among the 30 highest TB-burdened countries. Several factors account for unfavorable treatment outcomes, among which are patient characteristics. Previous studies have only focused on treatment compliance without any consideration for the factors that lead to noncompliance to treatment. The purpose of this study was to investigate patient characteristics that are associated with treatment noncompliance (treatment not completed) among TB patients undergoing the DOTS program in Sierra Leone. A retrospective longitudinal quantitative design was used to analyze secondary data from the completed records of 1,633 TB patients, using the Andersen's behavioral model of health services utilization as a theoretical framework work. Descriptive statistics and bivariate and multivariate logistic regressions were used to analyze the data. The results show that there was no significant association between treatment completion and age, gender, and TB-case category. On the other hand, being HIV-positive decreases the odds of treatment completion. Also, the educational level, geographic location, and year of treatment were significantly associated with treatment completion. Overall, program performance improved as the number of dropouts decreased significantly between 2013 and 2015. The social change implication of this study was that it identified HIV-positive patients and rural communities as areas needing specific attention such as the assignment of case managers to ensure compliance thereby improve DOTS program performance, thereby reducing the incidence and transmission of TB

More than 10 million people in the United States are known to have latent tuberculosis infection (LTBI), and more than 300,000 begin treatment for LTBI annually. However, many fail to adhere to therapy for numerous reasons. The purpose of this project was to evaluate the impact of a new guideline, Targeted Tuberculin Testing and the Treatment of Latent Tuberculosis, at inner-city tuberculosis (TB) control clinic in the United States. The practice-focused question for the project asked if the implementation of the clinical guideline using a shorter regimen improved LTBI treatment adherence. The health beliefs model was the framework used to guide the project. I analyzed data from deidentified LTBI treatment adherence records of 12 patients before the change to the shorter treatment regimens and 12 patient records 1 year after the change. Results after implementation of the new treatment guideline showed no improvement in adherence. Before the guideline implementation, 75% (n=9) of individuals had adhered to traditional therapy whereas, after the shortened course was implemented, only 66.7% (n=8) of the random sample adhered to treatment. It is important to evaluate new methods of treatment and determine success early to promote health and reduce complications of ineffective treatment of TB. These results can support positive social change by raising awareness of the need to evaluate new treatment effectiveness early. Such knowledge can help providers and clinicians examine the barriers to adherence to the medications used for treating TB and implement appropriate measures to overcome the obstacles.

Adult physical activity is important for prevention of chronic diseases and to minimize health issues; therefore, the motivational influences of sociodemographic variables on participation in organized physical activity events warrant an investigation. The purpose of this quantitative study was to investigate differences in motivational influences between various sociodemographic variables as related to physical activity events in organized settings. The theoretical framework that guided this research study consisted of the theory of reasoned action (TRA), and the health belief model (HBM). The TRA was applied to study the intention of health behavior, while the HBM was used to investigate individuals' motivation to engage in organized physical activity events. A cross-sectional study design in which an online survey consisting of the 40 item Physical Activity and Leisure Motivation Scale was used to collect data from adults who participated in an organized 5K or 10K running or walking event. The inferential statistical tests of the independent t test, one-way ANOVA, and ordinal logistic regression were used to determine the statistical relationships. The main research finding suggested that 6 motivational influences showed statistically significant relationship with organized physical activity events, which consisted of others' expectations (p = .025), competition/ego (p = .001), appearance (p = .001), affiliation (p = .034), mastery (p = .001), and psychological condition (p = .002) as it relates to their age group and gender. The research findings may be used to influence engagement in future organized physical activity events by understanding the sociodemographic variables relating to participation rates that may result in increased physical activity behavior within the community.